20-01_OGI

First ever use of pharmacogenomics in primary care

August 22, 2015

Challenge:

Mental illnesses are the result of a complex interaction between genetic and environmental factors. The recovery of people experiencing mental illness is a critical consideration for the Canadian healthcare system:

  • During lifetime about 20% of Canadians will experience some type of mental illness
  • Major depression (8%) and anxiety disorder (12%) are the most prevalent
  • At any time approx 10.4% of Canadians are suffering from acute or chronic mental illness
  • 79% of all short term disabilities and 82% of long term disabilities are related to mental illness, costing Canada $20.7 billion in 2012. (Conference Board of Canada estimate, July 2012).

However, many prescribed drugs are only effective about half the time, so finding the right medication is often the result of an ineffective trial and error approach, exposing patients to the risk of serious side effects and sustained suffering.

Genetic testing identifies patients who will not respond to specific medications or will experience side effects, thereby helping physicians prescribe the most appropriate drugs to each patient: maximizing the health benefits and decreasing the risk of side effects.

Genomics solution

Assurex Health is partnering with scientists at Toronto’s Centre for Addiction and Mental Health (CAMH) to develop the Enhanced GeneSight genomic test to better match patients with mental illness to antidepressant and antipsychotic medication based on their genes.

This project, funded through Genome Canada’s GAPP program, will deliver genetic testing in the primary care setting to determine the best medication for each patient based on their unique genetic profile. Patients are asked for a sample of saliva or a cheek swab, from which DNA is extracted. This DNA is tested for a number of genes that control how drugs are metabolized, how drugs interact with their targets in the body and their side effects. A report is delivered to the patient’s physician within a day or two. This report, using Assurex Health’s GeneSight panel, helps guide the physician as to which of antidepressant or antipsychotic drugs are best suited to that patient – enabling them to thereby avoid ineffective medication and reduce unnecessary side effects.

The GAPP project will validate new genomic markers that scientists at CAMH have identified for their ability to predict efficacy and side effects of psychiatric medications, including those that predict which individuals are likely to experience weight gain after taking anti-psychotic medications. The most predictive markers will be integrated into E-GeneSight. This is anticipated to reduce the need for “trial-and-error” approaches to prescribing and increase the likelihood that people will respond optimally to the medications prescribed for them, while reducing side effects.

Impact

Giving patients the right medication earlier can reduce the burden of mental illness for patients and their families, decrease the risk of detrimental side effects, and improve the quality of life of those affected by mental illness. Furthermore, reducing ineffective treatments will save the health care system money: decreasing physician visits, and reducing rates and length of hospitalization. Patients who recover faster need fewer healthcare dollars, are able to return to work (contributing to the tax base) sooner, and assume their role in their family and community.

Collaborators

Assurex Health, a global leader in personalized medicine, has signed an agreement for a joint venture with the Centre for Addiction and Mental Health (CAMH).  AssureRx Canada has been established as a subsidiary of the U.S. company, and will have an office and laboratory at CAMH.

 

Read the project description.